AUSTIN — Texas House Speaker Joe Straus is finalizing a plan to reverse controversial cuts in the rates paid to therapists for Medicaid recipients, but state Senate leaders say they will fight the proposal, which could turn the issue into a major sticking point in this year’s legislative session.

It would restore up to $350 million in reimbursements to therapists for physical, occupational and speech therapy provided to poor children with disabilities. Straus spokesman Jason Embry said the plan will be included in the House’s soon-to-be-introduced supplemental budget and carry forward into the chamber’s state budget proposal for the next two years.

The cuts were enacted in 2015, but delayed until last month due to a court battle. Already, they have led many therapists to stop serving Medicaid patients, which has made it harder for kids to get needed services. As many as 60,000 children ultimately could be affected, according to advocates.

Several senators said they still believe the lower rates are necessary. They pointed out that Texas pays higher reimbursements to providers than some other states and that money is tight because of the downturn in the oil industry.

A spokeswoman for Senate budget writer Sen. Jane Nelson, R-Flower Mound, declined to comment other than to say that the Senate is not proposing to reverse the cuts.

The disagreement illustrates one of the major differences between the House and Senate approaches to the budget for the 2018 and 2019 fiscal years.

The House’s initial proposal, which the Republican speaker from San Antonio rolled out earlier this month, provides about $65 billion in state and federal funds to Medicaid, which is about $1 billion more than in the 2016-2017 budget. The Senate plan, designed by Nelson and Lt. Gov. Dan Patrick, devotes $61 billion to Medicaid.

Experts and advocates for vulnerable populations have described the Senate budget as unrealistic and draconian, while Patrick has said that the House budget would spend money the state does not have.

Neither proposal restored the therapy rate cuts, but Straus aides said that is because the plan is to do so in the supplemental budget. Both chambers are expected to roll out their supplemental budget plans in late February or early March.

The fight already is getting underway, however.

The Senate Finance Committee held hearings on its health care budget and the proposal this week. Ahead of them, Nelson released a statement saying lawmakers would “meet our responsibility to vulnerable Texans and do what is necessary to protect endangered children” but “we must ensure that our resources are leading to positive outcomes and look for ways to contain our skyrocketing health care costs.”

Medicaid providers and advocates said they were optimistic that the House’s approach will win out. They acknowledged that because they lost their court challenge and the federal government recently declined to stop the cuts, this legislative session is now their best hope.

“We very much appreciate the speaker’s commitment to fix this issue that essentially is gutting the program as we speak,” said Rachel Hammon, executive director of the Texas Association for Home Care and Hospice. “Children with disabilities right now are going without services, so we just hope that the Senate will work with the House to correct this issue.”